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menstruation

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Female reproductive organs

Alternative Names
menses, period, menarche

Definition
Menstruation is the time during a woman's natural cycle when bleeding occurs from the vagina. Menstruation usually lasts between three and seven days.

What is going on in the body?
Menstruation occurs when one of the eggs in the ovaries is released. The egg travels down the fallopian tube towards the uterus. Once the egg is released, oestrogen encourages the uterus to build up a thick lining to prepare for pregnancy. If sperm from a male fertilises the egg, the egg implants itself into the uterine wall and begins to grow a foetus.

If pregnancy does not occur, the uterus sloughs off the lining and excretes it through the cervix, or opening of the mouth of the uterus. This excreted uterine lining is the menstrual flow. This cycle is repeated about every 28 days. The amount of time between menstruation may vary from woman to woman and month to month. Any duration between periods from 19 to 35 days is considered normal.

What are the signs and symptoms of the condition?
A woman who is menstruating may have no symptoms other than bleeding for three to seven days. Some women experience some difficulties with their menstruation. Some feel down or blue right before their periods begin. Others find that hair and skin becomes oily. Others have cramps when their periods begin.

Some women have PMS, or premenstrual syndrome. A woman with PMS may have bloating, breast soreness, swelling, fatigue, or irritability for up to two weeks before her period begins.

What are the causes and risks of the condition?
The cause of menstruation is the natural maturation of the female body. A female becomes ready to menstruate as young as 9 or 10 years old. Most will start to menstruate by the time they are fifteen. Women can have problems if hormones are thrown off balance. Irregular or missed periods may be caused by stress, changes in weight, diet, or illness.

What can be done to prevent the condition?
Menstruation does not need to be prevented. If a woman has her uterus removed for any of several medical reasons, she will no longer have a period.

How is the condition diagnosed?
A female knows that she has started menstruation when she begins to bleed. It is not necessary to see a doctor for diagnosis. But there are times when an evaluation by a doctor is necessary. Examples include unusual symptoms that do not seem normal for the person's menstrual cycle, such as extreme discomfort or severe bleeding. Routine pelvic examinations and PAP smears that should be done by a doctor.

What are the long-term effects of the condition?
Menstruation lasts from puberty to menopause. After menopause, a woman ceases menstruation and can no longer become pregnant.

What are the risks to others?
Menstruation poses no risk to others. Any history of sexually transmitted diseases, including HIV, call for careful disposal of tampons and pads in addition to good hand washing.

What are the treatments for the condition?
Women use a variety of menstrual products to control the flow of their period. Tampons, pads, sponges, cloth, and menstrual cups can all be used safely by most women to capture menstrual flow. The products come in various absorbencies for heavy and light flows. Over-the-counter medications like ibuprofen can help ease the pain of cramps. Severe cramping or bleeding should be brought to the attention of a doctor.

What are the side effects of the treatments?
Women who use tampons must be careful to change them often. Frequent changes keep bacteria from building. If bacteria build up, a woman may become ill with a potentially life-threatening disease called toxic shock syndrome.

What happens after treatment for the condition?
When menstruation ceases, a woman no longer needs tampons, pads, or other menstrual products.

How is the condition monitored?
Menstruation is generally not monitored unless a woman has premenstrual syndrome, is trying to get pregnant, or is entering menopause. For most women, menstruating is just a normal part of each month. A woman usually has physical signs, or knows by the calendar when her period is due.

If menstruation has not occurred and there is severe abdominal pain near the ovaries, immediate care should be sought. These symptoms may mean an ectopic pregnancy, or a pregnancy that is growing in the fallopian tube.

Author: Terry Mason, MPH
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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